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Bupropion vs Chantix

A guide to helping you work with your doctor to decide the right non-nicotine treatment for you

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There are two types of smoking cessation products, those that contain nicotine, and those that don’t.

One type is nicotine replacement therapy (NRT), which includes products such as gum, lozenges, sprays, and inhalers.  These work by giving you a small dose of nicotine without all the other dangerous chemicals found in cigarettes.  That way, you can wean yourself off nicotine while lessening withdrawal symptoms, although you may still have cravings. They don’t stop the cravings.  Most nicotine replacement products are available over-the-counter.

The other type of smoking cessation products are prescription drugs that don’t contain nicotine. They change the way your brain works to ease withdrawal symptoms and reduce cravings. The Food and Drug Administration (FDA) has approved two of these products: Bupropion (brand name: Zyban) and Varenicline (brand name: Chantix). So, let’s take a look at both drugs to help you work with your doctor to find the right treatment.

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Bupropion

Bupropion is the generic (common or non-branded) name for bupropion hydrochloride, the active ingredient in the branded drug, Zyban.

Originally marketed as an antidepressant drug under the brand name of Wellbutrin, it became apparent that Bupropion was an effective cessation aid, because smokers using it to treat depression also lost interest in smoking. People not planning to quit smoking found themselves stopping with relative ease.

Later, bupropion hydrochloride was given the brand name of Zyban and in 1997, the FDA approved it as a smoking-cessation aid.  When used in combination with nicotine replacement therapies (NRTs), the chance for long-term success with smoking cessation increases.

It’s important to be monitored by your doctor if you're using both Bupropion and an NRT, as there is a risk of developing high blood pressure from this combination.

It’s not clear exactly how bupropion works. Researchers do know that it blocks some of the chemicals in your brain that react with nicotine to make you feel good when you smoke. This then reduces cravings and eases other withdrawal symptoms.

Bupropion seems to be especially effective in reducing irritability and concentration problems. It may also help with the urge to overeat while you’re trying to quit.

Like all smoking cessation products, bupropion is recommended only for people who smoke 10 or more cigarettes a day, or about half a pack. Your doctor will probably have you start taking bupropion 1 to 2 weeks before you plan to quit, to be at peek effect when you do stop.

Most people take bupropion tablets for 12 weeks. 

Your doctor will start you on a 150 mg tablet in the morning, and may or may not increase this to twice a day. Evidence suggests that once-daily dosing is as effective as taking it twice, with fewer side effects.

Bupropion has many side effects, ranging from common, mild side effects,  to side effects which may require immediate medical attention.  Common side effects include dry mouth and trouble sleeping, but these problems tend to go away after you take Bupropion for about a week. You may experience anxiety, constipation, skin irritation, or dizziness.  If you’re concerned about other possible side effects, talk to your doctor as soon as possible.  Also, tell your doctor if you have a history of seizures, because this medication might make you more likely to have one. 

 

Chantix

Chantix is the brand name for the active ingredient, varenicline tartrate, which is also sold under the generic name, Varenicline. 

The FDA approved Chantix in 2006 to help people quit smoking. Studies show that taking it makes you two to three times more likely to quit for good.

Chantix works on the same parts of the brain that nicotine does. So, it gives you a good feeling without smokings harmful chemicals or lung dammage. 

By blocking certain chemicals in your brain, the drug also makes smoking less enjoyable. As with bupropion, you’ll start taking it a week or two before you quit. Those last cigarettes won’t be as satisfying as they used to be, so quitting will be easier.

Chantix tablets come in increasing doses, like bupropion. You’ll start off with 0.5 mg for a few days, then go up to 1 mg twice daily.

Like Bupropion, Chantix has many side effects.  The major side effect of concern is depression, suicidal thoughts, and behavioral changes. If you struggle with depression, or have a significant psychiatric disorder, this is not the medication for you.  In addition, Chantix can cause vivid dreams and nausea in some people.

 

Seek help to find the right quit-aid for you

Both Bupropion and Chantix can be used to help people quit smoking.  The major concern for many is that they have many side effects. 

It is essential to talk to your doctor about smoking cessation and treatment options.  You can also get free good support over the phone and help with different ways of quitting, from any of the national quit-smoking organizations, such as the National Cancer Institute (NCI).  Here are their contact details, including toll-free number:

 

References

  1. WebMD, What Are the Medicines for Nicotine Withdrawal? [website] 2019,  https://www.webmd.com/smoking-cessation/understanding-nicotine-withdrawal-treatment#1, (accessed November 2, 2019).
  2. verywellmind, How Zyban Can Help With Quitting Smoking, [website] 2019,  https://www.verywellmind.com/what-should-i-know-about-zyban-as-a-quit-aid-2825342, (accessed November 2, 2019).
  3. NIH, Chantix & Bupropion for Smoking Cessation (ChanBan), [website] 2013,  https://clinicaltrials.gov/ct2/show/NCT00587769, (accessed November 2, 2019).

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